I replace all my hormones. Here is what I learned.

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Hell.
Yes, I do regularly monitor my vital signs.

Around 4 months ago. Now I just use the occasional 3-5mg of HC when I need it (e.g. 2x per week). When I feel run down, I do use modafinil usually (30-50mg)

I meant would you mind telling us your average BP, resting HR, sleeping HR? As obviously with hormones it's unnatural. eg. I guess perfect would be 110/70 50 HR and 40 sleep. But now you are low thyroid maybe they are lower than when you were on all the hormones.

Modafinil mucks up my sleep too much, and raises my HR/BP but would be great otherwise.
3-5mg x 2 HC a week is nearly nothing so pretty good, so well done!
 
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Hormetheus

Member
RR: 120/70
Sleeping HR: 50
RHR: 60

They are actually now higher compared to what they were before, the reason being I added semaglutide which elevated my HR by 10 or more.

Whenever I need a stim, I take very small doses of ephedrine (i.e. 4mg -which is a very very small dose), which I like much better than caffeine.
 
They all seem really good, considering you are on no heart rate medications. That's a pretty low sleeping HR if that is your average—very interesting if they were lower than that on hydrocortisone.

Both those drugs seem very geared to appetite suppression. Are you fasting or something? I guess in theory it is good for you to not eat very much if there are no adverse side effects like a really fast heart rate. Briefly looking online, Semaglutide seems really expensive, unless its the oral.

Do you think your light stim usage enabled you to get off the HC? I'm thinking the stims must encourage adrenaline/cortisol/T4 to be produced if you supplement pregnenolone.

I would like to try a very low dose stim that doesn't keep me up like modafinil. Ephedrine looks interesting but powerful, I guess I would try that or ritalin really low dose in the future.
 

Hormetheus

Member
They all seem really good, considering you are on no heart rate medications. That's a pretty low sleeping HR if that is your average—very interesting if they were lower than that on hydrocortisone.

Both those drugs seem very geared to appetite suppression. Are you fasting or something? I guess in theory it is good for you to not eat very much if there are no adverse side effects like a really fast heart rate. Briefly looking online, Semaglutide seems really expensive, unless its the oral.

Do you think your light stim usage enabled you to get off the HC? I'm thinking the stims must encourage adrenaline/cortisol/T4 to be produced if you supplement pregnenolone.

I would like to try a very low dose stim that doesn't keep me up like modafinil. Ephedrine looks interesting but powerful, I guess I would try that or ritalin really low dose in the future.
Hello,
yes, my problem is likely hypothalamic (POMC neurons), which can be remedied by targeting these neurons using e.g. semaglutide.

No, I take the injectable and it cost me 140$ per month, however it is worth it.

No, stims do increase cortisol acutely, but it is very unlikely that they improve cortisol in the long run.

I also do not think that pregnenolone is of much help for increasing cortisol levels, as most people´s problem is not the adrenals but rather the hypothalamus.

I personally like ephedrine very much, however they do not sell it anymore because it can be used to make amphetamines from it.
 

Holden

Member
I am new to this group. Thanks for having me.
I want to share my journey with hormone replacement because I believe it might be useful to others.

My story: I am a medical student in my last year. I replace all of my hormones.

In early twenties my life was starting to go down the gutter. My life started to fall apart in every domain. At one point I was at the brink of suicide. I found out multiples of my hormnones were low.
I started hormone replacement. Whereas before my life was a nightmare, it has been great ever since. I have been doing this for some years now.

What I take. But what works for me might not work for others.


  • TRT: Test Cyp (50mg subQ 2x/week), HcG (250iu subQ 2x/week)
  • cortisol: cortisone acetate (20mg/d HC equivalent) (split into 4 daily doses)
  • thyroid: 1.25 grains NDT + 6.25mcg T3 (a few hours later in the day)
  • GH: 0.5iu genotropin pfizer (aiming for IGF1 of 250) prebed
  • fludrocortisone 01.mg/d morning
  • melatonin: 0.25mg sublingual prebed
Everyone is different, but the target range I aim for is in the upper tertile of the youthful reference range. Just falling somewhere within the reference range is not “optimal”. The reference range covers 95% of the population. Certainly more than 5% of the population have hormones bad enough to warrant intervention.

This is how I look now vs. then. .

If you are specifically interested in TRT, I wrote a guide about it here.

I am aware that this is rather uncharted territory, esp. in a DIY kind of way. As a medical student in my last year I am well aware of the risks. But to me the cost-benefit analysis is a no-brainer. If I had to, I would sign a contract to rather live 10 more years with my new vitality and then die instead of living to one hundred with the dreadful state I was in before.

I do extensive blood tests (complete hormone panel, metabolic health, general health) around every 3-4 months. I would´t dare doing anything (not even starting) without it.

Other stuff I do: keto/paleo, HIIT, weekly rapamycin, a bunch of supplements (all of them together less worth than a slight alteration in hormones), some exercise every day, sleep around 6h (wake up refreshed without alarm -before HRT I needed 8+).

After years of studying, researching, experimenting, testing I did a writeup about some stuff I have learned along the way.

My goal with all my writing is to point people into the right direction to remove biological shackles allowing them become the best version of themselves and live life fully.

Had I known what I know now, it would have saved me lots of time, money, happiness, effort, researching, experimenting. And suffering. I hope some of you find value in it . Enjoy.

How To Fix Your Hormones: The Ultimate Guide

I am open for any feedback and criticism.


I am sure some of you are quite knowledgable and experienced and might give valuable feedback/criticism and point out blind spots or other stuff I didn´t think about. What are your thoughts on all this? As I am in my mid twenties, do you think this is sustainable for decades?


For questions/feedback you don´t want to post here my email: [email protected]

What doctor or clinic did you use?
 

nodoctor

Active Member
Any updates on short/long terms semaglutide. Great thread and I've got some coming in. Will start very light and monitor blood sugar, but would love any other anecdotes or words of wisdom.
 

Hormetheus

Member
Any updates on short/long terms semaglutide. Great thread and I've got some coming in. Will start very light and monitor blood sugar, but would love any other anecdotes or words of wisdom.
Still effective for me. I describe my experience with it in detail soon with a new article I will post on my website. You may sign up for my newsletter to get notified when it is available. In there you´ll find in-depth the things I have noticed
 

nodoctor

Active Member
Looking forward to it. Mine just arrived. I'm thinking of doing .25mg one time to see how I tolerate it and then move up from there. I have 4mg and seems I can get more if it's good. Any tips much appreciated.
 

Hormetheus

Member
Looking forward to it. Mine just arrived. I'm thinking of doing .25mg one time to see how I tolerate it and then move up from there. I have 4mg and seems I can get more if it's good. Any tips much appreciated.
I have written about my experience with semaglutide here: The Simulated Refeed
I also share some tips and tricks and observations while using semaglutide. Never has a drug made as much of a difference for me.
 

nodoctor

Active Member
That is awesome to hear. I love your stuff and your list of misconceptions in conventional medical dogma reads like a laundry list of the things I think doctors have gotten wrong. i’m far less educated on a lot of these subjects, but one area that surprised me because you do not seem to be very focused on implementing least effective dose of these meds.

For example you stated your friend found .25 mg a week to be totally life-changing, but you are still doing a full milligram a week split in doses. I now plan to split my doses into three times a week, but I plan to start with a total of only .25 mg per week due to nausea concerns and hunting for the least effective dose in a conservative way.

I subscribed to your blog, but must admit I don’t plan to delve into getting up to speed on the chemistry concepts that it would allow me to truly understand a lot of the biological processes on a deeper level.

Thanks again for all of your very specific detail!
 
However, I have heard good things from Thierry Herthogues clinic.

Thierry Hertoghe is a pioneer for hormone replacement, especially in Europe. He also actively fought (and perhaps still does) for the legal rights to get or give these treatments. However, his approach to trt is a bit out of date: an injection every one or two weeks or a 10% non-scrotal cream to reach 75% of the reference range and an AI if estradiol is out of range.
He stopped treating patients, unless you are famous or willing to pay a lot, to focus on teaching. The doctors that see you instead just seem to copy his approach without really thinking much about it.
 
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Hormetheus

Member
Thierry Hertoghe is a pioneer for hormone replacement, especially in Europe. He also actively fought (and perhaps still does) for the legal rights to get or give these treatments. However, his approach to trt is a bit out of date: an injection every one or two weeks or a 10% non-scrotal cream to reach 75% of the reference range and an AI if estradiol is out of range.
He stopped treating patients, unless you are famous or willing to pay a lot, to focus on teaching. The doctors that see you instead just seem to copy his approach without really thinking much about it.
Hey, yeah Hertoghue is not up to date on hormone treatment. However, his approach of replacing multiple deficient hormones at the same time is great and not something that is done by conventional medicine
 

Hormetheus

Member
That is awesome to hear. I love your stuff and your list of misconceptions in conventional medical dogma reads like a laundry list of the things I think doctors have gotten wrong. i’m far less educated on a lot of these subjects, but one area that surprised me because you do not seem to be very focused on implementing least effective dose of these meds.

For example you stated your friend found .25 mg a week to be totally life-changing, but you are still doing a full milligram a week split in doses. I now plan to split my doses into three times a week, but I plan to start with a total of only .25 mg per week due to nausea concerns and hunting for the least effective dose in a conservative way.

I subscribed to your blog, but must admit I don’t plan to delve into getting up to speed on the chemistry concepts that it would allow me to truly understand a lot of the biological processes on a deeper level.

Thanks again for all of your very specific detail!I
I am glad that you found value in my article. Personally, i need 1mg, whereas my friend is fine with 0.25mg. All of us have a different sensitivity to things. Furthermore, I am a lot lower in bodyfat compared to my friend. GLP-1 agonists are leptin sensitizers. The more body fat you have (= lots of leptin), the less GLP1 agonist you need
 
T

tareload

Guest
If I had to, I would sign a contract to rather live 10 more years with my new vitality and then die instead of living to one hundred with the dreadful state I was in before.


Be careful there may be other options that you haven't fully explored.

I am 100% behind TRT, BUT I don't believe being in the upper part of say thyroid hormones to be "optimial" as longevity has been associated with higher TSH and lower TH levels.

Ah yes, "optimal" = put all your hormones, especially thryoid (fT4/fT3) in the top quartile. The issue is no one ever goes to the trouble of spelling out what the objective function was. Be careful out there guys.

To @Hormetheus credit, he does state an objective function. I want to feel great and push the limits of mankind's understanding of interventional endocrinology. 10 year horizon max. After 30 all bets are off.
 
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